Stark N, et al. - Researchers sought to determine the prevalence of persistent post-surgical opioid use. They also explored patient-related factors related to post-surgical opioid use. Persistent post-surgical opioid use was experienced by more than 10% of opioid-naïve patients undergoing elective surgery. A risk stratification tool may be developed using factors associated with persistent post-surgical opioid use, in order to predict those at highest risk.

Methods

• This study included 1,013 opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney.
• Preoperatively, study participants were asked to complete a questionnaire comprising potential predictors of persistent post-surgical opioid use.
• With routine perioperative care, patients underwent surgery.
• Opioid use was determined by performing follow-up at 90 to 120 days after surgery.
• Using logistic regression, factors associated with opioid use were evaluated.

Results

• Researchers obtained an overall response rate of 95.8% (n=970) of patients, of whom 10.5% (n=102) continued to use opioids at >90 days after surgery.
• On surgical subtype analysis, the reported prevalence of persistent opioid use after spinal surgery and orthopaedic surgery was 23.6% and 13.7%, respectively.
• In a multivariate model, the following 4 factors were shown to be independently associated with persistent post-surgical opioid use: having orthopaedic (odds ratio [OR] 4.6, 95% confidence interval [CI] 2.0 to 10.8, P <0.001) or spinal surgery (OR 4.0, 95% CI 1.7 to 9.2, P <0.001), anxiety (OR 2.1, 95% CI 1.1 to 4.1, P=0.03), attending pre-admission clinic (OR 3.7, 95% CI 1.6 to 8.6, P=0.002), and higher self-reported pain score at >90 days after surgery (P <0.001).